Is this postnatal depletion or perimenopause?
Are you an ‘older’ new mum? Are you over 35 and have given birth in the last 6 months or so? Perhaps you are feeling exhausted, moody, overly emotional or experiencing confusion or brain fog?
Let me take a guess - you're thinking this is normal! This is how you are meant to feel - with the sleepless nights, adjusting to new routines, juggling older children’s needs, breastfeeding or, even, returning to work - surely this is how it’s meant to be. You just have to keep battling on.
BUT is it normal? It might be common but is it normal? Should every day be a struggle?
Have you considered that you may be depleted, that your body may be drained of its nutrients, energy and resources to cope with the demands of the pregnancy and now your new life as a mum? Perhaps you are suffering from postnatal depletion?
OR, dare I say it, are you in PERIMENOPAUSE?
Yes, that’s right. PERIMENOPAUSE!
If you are over 35, your body could be in perimenopause - the stage of life that all women will experience as their hormones and body transitions to menopause (the time when your periods will cease forever).
So how could it possibly be perimenopause?
The average age of pregnancy and even first time mums is getting older. In the last 20 years, here in Australia, the rate at which women give birth has almost doubled for those aged 40-44 and quadrupled for those aged 45-49 years. We therefore have more pregnant women being classed as ‘older’ mums who will be more closely monitored during their pregnancy due to the higher risks of complications. In 2019, one quarter of women giving birth were aged 35 or over with just under a third of these having their first baby.
Perimenopause usually occurs during your 40s - it’s a stage of life. It doesn’t happen overnight! Think of it like puberty in reverse as it occurs over a number of years. For some women this may last up to 12 years. The average age for women to hit menopause is 51 years, so work out the maths and you’ll find that you might be starting your perimenopause journey in your late 30s. It may begin so subtly that you do not realise that your hormones are changing.
And yes! It’s still possible to fall pregnant right up until the point when you reach menopause even though the chances are significantly reduced.
So the older you are the greater the possibility that you are also in perimenopause as well as recovering from giving birth. You may have been perimenopausal before falling pregnant or you may transition directly into perimenopause after your pregnancy.
There are many physical and mental symptoms that are often experienced by women during perimenopause, including exhaustion, brain fog, mood swings and overwhelm. Sound familiar? Could it be that you are in perimenopause?
But what about postnatal depletion?
Postnatal depletion is particularly common in Western Societies, like Australia. It presents with a range of physical, psychological, mental and emotional symptoms, ranging from tiredness to depression, from self-doubt to feeling isolated. Every day may be a struggle to keep up with self care and looking after your baby (and family).
Your body has been drained of nutrients during the pregnancy and labour (and may still be with breastfeeding), you may be sleep deprived. You are likely low in a number of vitamins, minerals or other nutrients. Stress and inflammation stemming from your environment, your lifestyle, your food choices may be high. Once your body coped with it but it isn’t now. Your body needs time to rest, to recover and to be replenished.
Being an older mother, also makes it harder to recover from childbirth, and makes you more sensitive to sleep deprivation plus it's harder to re-regulate your hormones. It’s hard to find the village of support that previous generations would have had or that is still experienced in some parts of our world.
So is it postnatal depletion or perimenopause?
To be honest, if you are in your 40s and have recently given birth, it is hard to know! Both postnatal depletion and perimenopause are often overlooked by your doctor as reasons for your tiredness, your emotional outburst, your low moods and so on. You may be told that it’s just normal, that you just have to put up with it or you may be diagnosed with postnatal depression or something else. But this may not be the response you want to accept.
There are many symptoms that are common to both postnatal depletion and perimenopause including:
Hot flashes/night sweats
Breast swelling & pain
Anxiety & Depression
So what can you do to help yourself?
Whether it is postnatal depletion, perimenopause or even postnatal depression, it is important to ensure that you are:
Eating healthy, wholefood meals - ensure you are having at least 3 regular meals a day, you may find you need to eat 5 smaller ones instead - every woman is different. Don’t skip breakfast (have it a little later but don’t miss it altogether). Ensure you are eating adequate protein (meat and non meat sources), plenty of vegetables (especially the leafy greens to support the balancing of your hormones and detoxification), healthy fats (avocado, olive oil, nuts & seeds) and some complex carbohydrates (brown rice, wholegrain breads (if tolerate), legumes, starchy vegetables). Try to cut down on sugary, ‘white’ and processed foods. Avoid alcohol, too much coffee and drink plenty of water.
Find a way to exercise - not intense, but a way that is enjoyable, that is gentle that will help you destress, revitalise and not drain your energy further. A walk in nature (with the stroller) will be a great start with the added benefit of a Vitamin D boost from the sunshine.
Filling your own cup first! You cannot care for your new baby if you cannot care for yourself first. As an older mother, your body and mind needs to slow down and to be nourished too. Take a few moments each day to ‘breathe’, to be mindful, to meditate and to rest when you can. Find your village to support you.
As an older mother, you may take longer to recover from pregnancy. You may be postnatally depleted, you may be in perimenopause or you may be experiencing both at once. A healthy diet, regular gentle exercise and self care will help with both. It will also help with perinatal depression and anxiety which could also be associated with postnatal depletion and/or perimenopause.
If you are an ‘older’ mum, experiencing tiredness, low moods, or any other symptoms related to depletion, perimenopause or postpartum recovery, then I would love to help you to replenish, recover and enjoy being a mum.
Please Note: In support of Perinatal Mental Health Week (6-12 November) 5% of any initial consultations* for support with pregnancy and postpartum care during November 2022 will be donated to PANDA (Perinatal Anxiety & Depression Australia).
*Consultation must be booked, paid for and conducted during the month of November 2022.
Baldwin MK, Jensen JT. Contraception during the perimenopause. Maturitas. 2013 Nov;76(3):235-42. doi: 10.1016/j.maturitas.2013.07.009. Epub 2013 Aug 8. PMID: 23932427. (abstract only)
Tarlatzis BC, Zepiridis L. Perimenopausal conception. Ann N Y Acad Sci. 2003 Nov;997:93-104. doi: 10.1196/annals.1290.011. PMID: 14644814.(abstract only)
AIHW (2019) Older mothers in Australia 2019 https://www.aihw.gov.au/reports/mothers-babies/older-mothers-in-australia-2019/summary
McMahon CA, Boivin J, Gibson FL, Fisher JR, Hammarberg K, Wynter K, Saunders DM. Older first-time mothers and early postpartum depression: a prospective cohort study of women conceiving spontaneously or with assisted reproductive technologies. Fertil Steril. 2011 Nov;96(5):1218-24. doi: 10.1016/j.fertnstert.2011.08.037. Epub 2011 Oct 1. PMID: 21963230. (abstract only)
Serallach O, 2018), The Postnatal Depletion Cure, Hachette